LECTURE 9 (Catheterisation of central vein) Flashcards
What is a Central line?
An IV line that is much longer and goes all the way up to a vein near the heart or just inside the heart
What is the function of a Central line?
- Patient can receive medicine, fluids, blood or nutrition
- Used to draw blood
- Used when a catheter cannot be inserted in to an arm or a leg vein
When is Central vein catheterisation needed?
- Care of critically ill patients
- Allow for administration of vasoactive medications + agents (venous irritants)
- Used to perform dialysis or plasmapheresis
- Used to insert additional devices for more complex procedures
Where are the placement sites of CVC insertion?
- Internal jugular vein
- Femoral vein
- Subclavian vein
Which locations are the direct paths to the right atrium?
Right internal jugular vein & Left subclavian vein
Explanation: direct paths to the right atrium via the superior vena cava
The subclavian vein approach is at higher risk for ______________ than the internal jugular vein approach
Pneumothorax
What are the properties of Femoral vein catheterisation?
- Compressible sites
- More appropriate for coagulopathic patients
Why is the Internal Jugular Vein often chosen?
- Reliable anatomy
- Accessibility
- Low complication rates
- Ability to employ ultrasound guidance during the procedure
In which position should the patient be placed for the Internal Jugular and Subclavian approach?
Trendelenburg’s with the head turned to the opposite side of the site
What Local anaesthesia is used?
1% Lidocaine
What are the local complications of CVC?
- Hematoma
- Cellulitis
- Thrombosis
- Phlebitis
What are the serious complications of CVC?
- Embolism
- Vascular erosions
- Pericardial tamponade
- Pneumothorax
- Thrombosis
- Catheter associated infection
- Misinterpretation
